Royal Trinity Hospice Annual Report and Account 2022-3

Annual Report and Accounts 2022-23

Outgoing and Incoming Chair’s letters, September 2023

Adrian Williams, Outgoing Chair

Trinity exited from the Covid-19 pandemic in good shape in strategic, operational and financial terms. We are rebuilding our core services strongly and we plan further significant growth in our patient reach and care offering this year.

Operational performance

Total patient numbers were 9% up as our patient-facing teams worked hard to relaunch our full suite of services to meet rising demand. Lower inpatient volumes resulted from staff shortages (as seen across the health system) but bed occupancy rose consistently over the last 6 months as recruitment activity bore fruit. In October we introduced a new electronic patient record, a key step to future-proof clinical services and optimise integration with other healthcare professionals.

Quality is the cornerstone of all we do, and I am delighted that our CQC “Outstanding” rating remains in place. Our teams work hard to ensure that we consistently deliver high-quality services to patients, families and healthcare system partners.

Our strategic aim is to reach 50% more people by 2030. Our Transform project plans to launch four new services in 2023-24; a clinical hub, a community rapid response service, a virtual hospice ward and a Living Well programme - all supported by our Every Person Matters fundraising campaign.

Financial performance

Solid financial results reflect the energy of our Fundraising and Retail teams and our donors’ generosity. We reported record retail profits and had a strong fundraising year as well. Careful management of costs, capital expenditure and liquidity means that we end the year with a stable overall position that gives us the confidence to make targeted growth investments and help us to meet the longer-term structural challenges of rising demand and falling real NHS funding.

As I step down, I want to thank the board, executive and staff teams who demonstrated exceptional leadership and commitment over the last few years. They navigated Covid-19 and its aftermath and strengthened and energised Trinity, leaving us with a great staff team, excellent services, and an innovative approach to working with patients, families and local health partners. This platform positions Trinity well to expand patient reach significantly, while maintaining outstanding service quality and financial resilience.

People

These achievements reflect the unceasing work of Trinity’s staff and volunteers. This team delivers outstanding patient and family care and raises the bulk of our funding. Quite simply, our team is the heart of Trinity and I want to recognise and thank each team member for their work. Our new People Plan has a range of initiatives to support staff and volunteers, including targeted cost of living support for lower paid team members.

I am delighted to welcome Prof Suzanne Shale as my successor. Suzanne has a strong track record in health and social care, and I am sure she will, with the board and management, guide Trinity successfully in the years ahead.

Yours sincerely,

Prof Suzanne Shale Incoming Chair

It is an immense privilege to be invited to participate in shaping the future of this exceptional organisation.

In my previous volunteering role at Trinity, I supported those experiencing bereavement. Their stories constantly reminded me how very important it is to care for people with compassion and kindness, as well as with exceptional clinical and pastoral expertise. In my conversations with staff and patients’ families since I have become chair, I have seen and heard how these values permeate our organisation.

Trinity is now in its next exciting phase, ensuring that we can give care and support to all those who need our services across central and south west London. This means growing the size and scope of the care we provide to people in their own homes while continuing to meet the need for our inpatient unit and the other services we offer at the hospice itself.

Trinity is nothing without people – patients and their families, staff and volunteers, donors, supporters, customers, and our NHS colleagues and partners. I look forward to continuing to meet you, listening to what you have to say and working together to ensure we continue to make Trinity the best it can be.

Trustees Report for the year ended 31 March 2023

Section 1: objectives and activities

The trustees of Royal Trinity Hospice present their report, together with the consolidated financial statements of the charity and its subsidiary company for the year ended 31 March 2023.

Royal Trinity Hospice: Why we are here

Trinity provides expert, compassionate specialist palliative and end of life care to around 2,300 people in central and south west London every year.

We care for adults with progressive, lifelimiting illnesses, helping them to make the very best of every moment they have left. We strive to enable people to have a ‘good death’ and we support those who are left behind when someone dies.

We aim to support patients and their loved ones with their physical, emotional, spiritual and practical needs, wherever they are. We provide nursing and medical care, emotional and practical support, welfare advice, occupational and physiotherapy, complementary therapies, spiritual care, counselling, psychiatry and bereavement

Our vision, mission and values remain unchanged:

“To be the local hospice of choice for all those who need us, and an example of excellence in end of life care”

support to those who have been affected by the death of someone under our care.

We care for people in our community and through inpatient and outpatient services in modern, welcoming facilities at our base in Clapham. Most of our care happens outside the hospice building, in our patients’ own homes, care homes, nursing homes, homeless hostels and prisons.

We share our specialist skills through education and support for other care providers, such as GPs, district nurses, hospitals and care homes, so that more people in our community have a better experience of care at the end of their lives.

It costs £17 million each year to run Trinity. All our care and services are free to patients and their loved ones. We receive around a quarter of our funding from the NHS and raise over £11 million each year through the generosity of our local communities and supporters, from legacies, trust and corporate funders, and those who donate to and shop in our high street shops.

> To provide expert and compassionate end of life care, support, information and advice to patients and those close to them

> To provide education and information, working collaboratively with all health and social care providers, to ensure as many people as possible benefit from our expertise

> To improve communities’ relationship with death and dying, allowing them to live every moment

> To challenge and overcome barriers to equity, diversity and inclusion in our services

> To be true to our values and a good employer

Strategy: our progress against priorities for improvement 2022-23

Last year we published a new five-year strategy with the ambitious goal ‘to expand our reach to all of the people in our community who would benefit from our services, through an inclusive and collaborative approach to delivery while maintaining outstanding quality and financial balance.’

We delivered the first year of activity against our five-year objectives:

To make best use of our existing workforce model and facilities, utilising digital and virtual working.

To extend our reach across all our diverse communities – particularly those who traditionally do not access palliative and end of life services.

To strengthen our collaboration with partners, utilising innovative pathways.

To invest in expanding our services, workforce, and facilities.

To ensure fundraising, retail operations and NHS income matches growth in activity and associated operational costs.

Objective 1: To make the best use of our existing workforce model and facilities, utilising digital and virtual working.

What we did in 2022-23

> We focused on quality and CQC preparedness by investing in Executive Director of Nursing and Head of Improvement roles.

> Our Patient and Family Support team re-established face-to-face bereavement and counselling services.

> Our Community Nursing team redesigned how they manage caseloads. They standardised the process of assessment and how they deliver care to ensure consistency across the service.

> To improve infection prevention compliance, we have brought our cleaning and housekeeping services in-house.

> We rolled out a new electronic patient record system which integrates with primary care to reduce time spent gathering information on new patients.

Objective 2: To extend our reach across all our diverse communities, particularly those who do not traditionally access palliative and end of life services.

What we did in 2022-23

> We established a new Community Engagement team who launched our Compassionate Neighbours programme in January 2023. The project supports people who are socially isolated, lonely and of advanced age or illness.

> We appointed a lead Community Nurse Specialist (CNS) for learning disabilities to identify and remove barriers to care, and to educate Trinity staff and other healthcare professionals on the needs of people with learning disabilities, including workshops delivered by the Baked Bean Theatre Company.

> We expanded the work of the Homelessness Working Group, changing our processes and working with local hostels and partners to improve our offer to homeless patients.

> Our Spiritual Care Lead created links with local faith leaders and launched a series of educational sessions where clinical staff learn about end of life care traditions and practices for different faith groups and potential barriers to access our care.

> We launched a series of “Talk & Tour” events inviting people into the hospice and a suite of talks and training products to community and faith groups with whom we are continuing to develop relationships.

> The FREDIE Working Group launched a series of monthly focus topics combining education/awareness activities.

> We published Trinity’s Anti-Racism Action Plan and are progressing against its objectives.

Objective 3: To strengthen our collaboration with external partners utilising innovative pathways.

What we did in 2022-23

> We have been actively involved in the north west London review of community specialist palliative care provision to shape the future model of care.

> We launched a new electronic patient record system which will ultimately allow us to access the NHS spine and better share information with other healthcare professionals involved in our patients’ care.

> We rolled out Universal Care Plans to allow up to date communication with all healthcare professionals through a shared care record.

> We introduced new data warehouse software to improve our data management, impact monitoring and reporting.

> We continue to provide education programmes for healthcare professionals to raise the quality of end of life care. We provided palliative and end of life care classroom-based training to student paramedics, in addition to supporting feedback on how they manage simulated patient scenarios as part of their core training.

> We agreed collaborations and strengthened relationships with our neighbouring hospices.

Objective 4: To invest in expanding our services, workforce, and facilities

What we did in 2022-23

> We redesigned the clinical model of care for the hospice through the Transform programme. We will be incrementally introducing this new programme throughout 2023-24 and beyond.

> We finalised the People Plan (Employer of Choice and Volunteering) and delivered the first year of activity which has included enhanced recruitment and retention initiatives and an expanded learning, development and wellbeing offer.

> We created new roles for our people to develop their careers in nursing by establishing partnerships with two London universities to develop Nursing Associates and Nursing Apprenticeships. We partnered with another university to train Return to Practice Nurses.

> We recruited 4 new nurses onto the community rotational CNS development programme to teach and develop staff in-house to become Clinical Nurse Specialists of the future.

Objective 5: To ensure fundraising, retail operations and NHS income matches growth in activity and associated operational costs

What we did in 2022-23

> We delivered on our retail strategy, with all of our shops recording their best year and we exceeded our total budgeted profit by 18% across the estate.

> We opened two new shops: one in Earl’s Court, and one a stone’s throw from the hospice on Clapham Common.

> We refurbished our shop in Notting Hill and continued to refresh others.

> Despite significant challenges caused by the economic and political environment we met the fundraising target of £4m.

> We reintroduced events that had been on-hold during the pandemic, including the annual Summer Garden Party, and redesigned the Light up a Life event.

> We introduced our new Online Tribute Funds, trialled a new raffle product and launched a new legacy campaign to bolster our future legacy income.

Section 2: Achievements and performancethe impact of our core services in 2022-23

2,651

Patients received our care and support, which is 9% more patients than the year before

2,989

1,939

People received support from the community nursing team

Home visits by the community nursing team which is an increase of over 150% on the previous year when home visits were limited due to the pandemic and an 18% increase in the year before the pandemic

569 Patients supported by physiotherapists, occupational therapists, and complementary therapists

3,239 Visits were completed by the Royal Trinity Carers

240 People benefited from 1,172 bereavement support sessions

338 Carers received formal psychosocial, spiritual or welfare support

21,730 Telephone calls by the community nursing team

240 People benefited from bereavement support

238

Patients received care on the inpatient unit

2,253

Total number of people supported (includes carers or separate patients and family members who received support)

2,092 Patients received care in their own homes, which is where over 85% of our patients receive care. This includes patients supported by the Community Nursing team, PAFS, Wandsworth end of life care coordination team, and the Therapies team

4,515 The number of bed days provided in the inpatient unit

206 Complementary therapy appointments provided for patients by Trinity volunteers

331 Urgent Care Plans were created followed Advance Care Planning discussions.

554 People received care coordination support

Community care

Most of our care is provided to people in their own homes, including care and nursing homes.

Trinity’s team of specialist community nurses supports people by providing expert advice for symptom control and supporting the coordination of services with the person’s GP, district nursing team, hospital team and social services. Many of our other specialist

staff also provide services to people in their own homes, including the Patient and Family Support team, occupational therapists, and the Medical team.

The Community Nursing team provides home visits seven days a week as well as a 24/7 telephone support service. This year has seen a significant increase in home visits from the Community Nursing team as Covid-19 restrictions and guidance have continued to ease.

Inpatient care

Trinity’s inpatient unit has 28 beds, and the Inpatient team provides skilled, compassionate care in a warm, welcoming and modern environment. People are admitted for many reasons, including for support to get difficult physical or psychological symptoms under control before returning home, rehabilitation to continue to live independently, or end of life care when an illness is advanced.

In line with many other health and social care providers, we have found that staffing the unit has become increasingly challenging this year. These challenges have led to the tough decision to reduce our bed capacity to maintain our favourable staff to patient ratio. We have invested significant time in the recruitment of nurses, including attending healthcare recruitment fairs and partnering with national and international nursing recruitment agencies. At the same time, we have concentrated our efforts on developing our existing workforce.

This approach has successfully reduced the overall nursing vacancy, which has allowed us to increase our inpatient bed base. Nursing recruitment remains a priority. Continuing at our current rate, our aim is for all beds to be open and in use by Q3 23-24.

Dementia care

Our community dementia service is available for people who live in their own home or in a care home within Trinity’s catchment area. The service aims to ensure people

living with dementia, and their families and friends, have the same access to specialist palliative and end of life care as those living with other progressive, life-limiting illnesses such as cancer.

Our community dementia team provides advance care planning, support for families and friends who care for someone with dementia and advice and training for professionals who care for people in the later stages of dementia

Our specialist inpatient bay has been designed as a “home from home” for people with dementia. We provide up to two weeks respite within a twelve-month period.

Support for family and friends

Support for those closest to our patients is integral to our care. Our Patient and Family Support team provides multidisciplinary support across five key areas:

> Social Work

Providing assessment, practical and emotional support to our patients, their carers and families. The team is often the first on hand to talk to patients and family members about any

worries and concerns they may have and will advise where appropriate.

> Welfare Benefits Advice

The team provides information and advice about the benefits and other financial assistance that patients and carers may be entitled to, as well as help and advice on how to apply. They can also help with any financial concerns, debts, tenancy queries, homelessness, Wills and Lasting Power of Attorney.

> Counselling

Our Specialist Palliative Care psychological support team can support patients and family members in exploring psychological and emotional difficulties and concerns arising from an end of life diagnosis. The team of staff and volunteers offer structured counselling sessions both face-to-face and virtually.

> Bereavement Support

The Bereavement Support team provides emotional support and counselling delivered by expert volunteer counsellors and trained bereavement support workers.

> Spiritual Care

Spiritual Care can allow patients and carers to connect to something greater in life and help facilitate a reconnect to self. Our team can provide the space for reflection and reconnection allowing one to make choices based on personal values and beliefs.

Wandsworth End of Life Care Coordination Service (WEOLCCS)

Trinity manages a care coordination service in Wandsworth on behalf of Battersea Healthcare CIC (the multispecialty community provider in Wandsworth CCG). The service coordinates care for patients receiving end of life care and provides short-term care and support through a dedicated team of rapid response carers, the Royal Trinity Carers.

Therapies support The Therapies team provides person-centred interventions for patients to maintain their independence and safety for as long as possible, enabling people to remain in their preferred place of care or death. They

also provide non-pharmacological management of symptoms such as pain, breathlessness, fatigue, and anxiety.

The Therapies team offers:

> Physiotherapy to support patients to maintain and improve their strength, balance, and mobility, both in the community and on the inpatient unit. The team works closely with occupational therapy to provide rehabilitation, falls management and manual handling advice to ensure safety at home and avoid unnecessary hospital admissions.

> Occupational therapy to support people to maintain their daily activities through rehabilitation, equipment and education. The team works on the inpatient unit and in the community, assessing and addressing difficulties with transfers, fatigue, personal care tasks, positioning, and meaningful activity.

> Complementary therapy uses massage, aromatherapy, acupuncture, and reiki to support the management of symptoms such as pain, breathlessness, nausea, fatigue, peripheral neuropathy and anxiety.

Community engagement

In 2022 we established a new Community Engagement team to proactively build relationships with communities and community groups across our catchment. Working collaboratively with teams across the hospice, the Community Engagement team aims to:

> grow awareness of the hospice among those who could benefit from our care;

> improve the confidence and knowledge of people living in our community to talk about issues relating to death, dying, serious illness and bereavement;

> reach out to people in our catchment who are disengaged with their community and socially isolated due to their advanced age or illness;

> identify real and perceived barriers to end of life and palliative care for communities throughout our catchment area and work with colleagues across the hospice to overcome them.

In January 2023 the team launched Compassionate Neighbours at Trinity. Compassionate Neighbours is an established community engagement model used in multiple hospices which matches trained members of the community with people approaching the end of life due to age or illness who are lonely and socially isolated. The project aims to have matched 30 people with a Compassionate Neighbour by the end of 2023-24 and trained 50 Compassionate Neighbours.

Complaints and compliments

We received 4 formal complaints in 202223 (compared with 10 in 2021-22). Of these, 3 were resolved and upheld and 1 was partially upheld. We received 14 concerns (compared with 24 in 2021-22). All were discussed with the parties involved and have been resolved and closed.

We recorded 131 written or verbal compliments. Compliments received by patients and families are shared with staff. More information on the learning outcomes from these complaints and the actions that we have taken can be found in our Quality Account at: royaltrinityhospice.london/quality

Education Training and education development for staff

We share our education platform with other hospices, local authorities and care homes who may wish to participate in our programme to support staff development in relation to palliative and end of life care.

We offer workshops to external healthcare professionals and our own staff throughout the year. These blended learning courses include elements of personal study and “live” learning online or inperson. We also offer bespoke training for homelessness support workers in our catchment area and staff working in care homes throughout Wandsworth.

Section 3: Financial review 2022-23

The financial year 202223 was a year of planned investment. Trinity set a deficit budget, planning to invest our surplus from the past two years in our people, building and retail operations to fund growth for the future to meet growing demand for our services.

The Retail team exceeded all expectations, with the increased income supporting our investments in the year. The Fundraising team met their ambitious budget in a particularly challenging year which was influenced heavily by the national and wider global economic situation. We continue to have adequate levels of reserves and the Board of Trustees plans to further invest in 2023-24 to support our plans for growth.

Income was £15,640,826 for the year ended 31 March 2023, which was a 4.5% decrease on 2022 (£16,379,644). Total Retail income increased by 19% from £5,545,425 to £6,661,793 reflecting better trading conditions post-Covid but more importantly the success of the new retail strategy.

Core patient services income increased from £4,004,075 to £4,526,365 driven by an uplift in the core NHS contracts and additional income for opening extra beds on the ward during the winter of 2022-23.

The year proved to be challenging for fundraising resulting in £1.3m less from legacies and lower returns spread across other fundraising income streams. Overall, Fundraising income decreased to £4,042,228 from £6,014,918 in 2022 reflecting lower probate values for legacies than the previous year. However on a cash basis, our fundraising ended the year just shy of achieving its overall target.

*Contribution is stated before depreciation. Figures included are revenue for the relevant area less direct costs and a share of overheads.

Total expenditure increased by 20% to £17,255,074 (2022: £14,317,867). The cost of inpatient, community and outpatient care increased by 25% to £11,745,742 reflecting the demand for our services after two years of Covid restricting activities. The costs of the trading subsidiary increased by 10.8% to £4,631,102 as shops were operating all year round compared to 2021-22. Fundraising costs increased by 16.5% to £874,370 as the Fundraising team continued to build back up to pre-pandemic levels (2021-22: £750,575). We ended the year with a deficit of £1,614,249 (2022 surplus: £2,061,777). The table above adjusts this figure, removing the cost of depreciation and adding the cost of capital expenditure to show the operating cash (deficit)/surplus.

Reserves

The trustees regularly review the reserves requirement for the hospice. The Board has adopted a liquidity and risk-based approach to reserves, recognising that Trinity’s funding and asset base remain well-diversified.

The reserves policy aims to ensure we hold sufficient investment and operating cash to cover the risks associated with short term income volatility, notably retail and legacy income. Trustees agreed to continue to reinvest investment cash into our equity investment fund, because the need to hold such large levels of cash have been reduced. Trinity’s policy is to hold at least 3 months’ operational expenditure in cash and investments plus cash to cover 6-8 months of operational expenditure. At March 2023 Trinity held cash plus investments equal to 7.4 months of cash cover (£10,430,940).

At 31 March 2023 free reserves, the General Purpose unrestricted fund, decreased to £10,705,232 which equals 7.6 months’ running costs (2022: £12,043,770, 10.5 months’ running costs) (see note 16).

Designated Funds decreased from £12,088,234 to £11,718,194 during the year (see note 16) and represent the net book value of our fixed assets and the market valuation of our investment property. The reduction is due to depreciation of fixed assets less the assets purchased in the year and a £100k reduction in the market value of the investment property.

Restricted Funds decreased from £276,044 to £146,039.

Investment policy

Aside from retaining a prudent amount in reserves each year, most of Trinity’s funds are spent in the short term on end of life care provision. The investment portfolio is strategic capital and is to be used to facilitate key Board objectives. It is not intended to support general running costs but provides a cushion against any shortterm income volatility. The Finance and Resources Committee reviews the investment portfolio performance every six months. We liquidated investments in March 2020 and began reinvesting month by month from March 2021 which has continued throughout 2022-23. No investments were sold during the year and investments totalling £1,050,000 were purchased. Trinity owns The Elms, an investment property currently valued at £4,900,000.

Performance of the investment portfolio is targeting, over the long term, to achieve 3% above inflation. A composite benchmark is also set for CCLA to outperform, which it did during 2022 in challenging conditions. Performance is also benchmarked against the ARC Steady Growth peer group of multi asset mandates for charities.

2022/23 has been an incredibly challenging year for global investments against a backdrop of high inflation. The investment portfolio has therefore performed well below the target for the year and incurred capital losses of £139k for the financial year (2021/22: £53k gain).

Changes in fixed assets

The movements in fixed assets during the year are set out in note 9. The trustees are of the opinion that the open market value of the property is in excess of the book value shown in the financial statements.

Fundraising

Fundraising activity update

Despite significant challenges caused by the economic and political environment. Fundraising net contribution on a cash basis was £3.95m - only £17k from the target set. We reintroduced events that had been on hold during the pandemic including the annual Summer Garden Party which raised £100k. We welcomed 100+ people to our redesigned Light up a Life event at the hospice in December.

During the year we introduced our new Online Tribute Funds which raised £180k, trialled a new Raffle product that raised £20k and acquired 30 new donors, launched a new legacy campaign to bolster our future legacy income, and developed several new events and campaigns to be launched early in the new financial year. This includes the major Every Person Matters Campaign which will seek to fund our growth strategy with an extra £4m raised over the next three years.

Fundraising compliance and governance

Trinity is committed to its donors and remains dedicated to treating all donors and supporters with the highest level of care, consideration and respect. The trustees take their responsibilities under the

Charities (Protection and Social Investment) Act 2016 seriously and have considered the implications on their fundraising activities.

Trinity is registered with the Fundraising Regulator and abides by the Regulator’s Code of Fundraising Practice and the Fundraising Promise. Great care is taken to ensure that all donors are treated fairly and are enabled to make informed decisions about any potential donation. If required, the Fundraising team draws on the resources of the healthcare professionals based in the hospice to support a judgement about a donor’s potential vulnerability or lack capacity and always err on the side of caution.

Trinity contracts all fundraising activities to Compton Fundraising Consultants Ltd (Compton). Compton provides expert fundraising services to ensure that Trinity has sufficient funds to provide end of life care to all who need it. Fundraising activities delivered by Compton include individual giving, legacies, trusts and foundations, corporate partnerships, community and challenge event activity, in memory giving, major donor fundraising and events.

The Compton team at Trinity does not engage in cold-calling or wealth-screening and does not buy or sell data. All data is managed and stored securely by Royal Trinity Hospice. Compton does not use other agencies in their fundraising activities on behalf of Trinity with the exception of Legacy Link, a legacy administration company, which Compton contracts to administer the legal process of legacy donations. Compton is a founding member of the Association of Fundraising Consultants. Senior staff are members of the Institute of Fundraising and all staff adhere to the Fundraising Regulator’s Code of Fundraising Practice.

The Compton team is fully integrated with the charity and works full time on the hospice site. The Director of Fundraising is a Compton employee who reports to the Trinity Chief Executive and sits on Trinity’s Executive team. Compton attends and reports quarterly to the Board via the Finance and Resources Committee and the Fundraising Development Group.

The Fundraising team is bound by the policies and procedures set by the hospice and is monitored against those via Trinity’s

corporate governance structure. The Director of Fundraising is a member of Trinity’s Information Governance Group and a member of the Fundraising team attends the hospice’s Health and Safety Group. The Fundraising team works closely with Trinity’s Data Protection Officer to ensure data processing is in line with the requirements of the GDPR and Data Protection Act 2018 and the agreed application of this.

Trinity received 5 complaints in relation to fundraising, all of which were minor and were resolved (previous year: 8).

Trinity’s Donor Charter sets out how we assure current and potential donors of the integrity and high standards of fundraising at Trinity and can be read at: royaltrinityhospice.london/donor-charter

Royal Trinity Hospice would like to thank everyone who has supported us with financial support through donations, grants, legacies and fundraising over the past year. We would also like to thank the Julia and Hans Rausing Trust and The London Community Foundation, via The Wimbledon Foundation Community Fund.

Retail

Retail activity update

During 2022-23 our retail business had another very successful year achieving its best ever year with sales of £6.1m out of a total income of £6.7m (which includes gift aid) and profit of £2m, up from £5.1m and £1.5m in 2021. We opened two new shops in Earls Court, SW5 and one a stone’s throw from the hospice on Clapham Common. In addition to the two new locations, we refurbished our shop in Notting Hill and continued to refresh others.

Every one of our shops had their best ever trading year and we exceeded our total budgeted profit by 18% across the estate.

In 2023/24 we plan to open a further two shops, with Wimbledon due to open in July 2023. Along with the new locations, we will

continue with our upgrade programme and invest in three existing shops, Islington, Putney & Northcote Road during this year.

We continued our mission to be “London’s answer to sustainable fashion,” and in 2022 we further strengthened our position by signing up 61 new corporate fashion brand partners and increasing the quality of our over-the-counter donations.

During 2021 we invested in additional assistant managers to better cover the trading week within the shops. This has resulted in us being able to appoint all shop manager vacancies throughout 2022 with internal applicants, providing career progression opportunities to those who wish to further their careers.

Section 4: Structure, governance and management

Risk management

Risk management is fundamental to good management practice and a significant aspect of corporate and clinical governance at Trinity. The overall management of risk is the responsibility of the Chief Executive. Our risk management framework is a formal acknowledgement of our commitment to manage risk in a proportionate, meaningful and responsible manner.

In December 2022 we moved to a new system for managing risk, utilising the NHS Board Assurance Framework.

The key risks for the organisation are:

Risk Mitigation

Demand for services exceeding capacity

Infrastructure failure impacting delivery of healthcare

Economic environment impacting on fundraising ability

Reputational damage due to any noncompliance with governance or regulatory requirements

Economic environment impacting on investments

This is mitigated by our growth strategy, the planned implementation of our new clinical model of care via the Transform programme and a specific project looking at inpatient unit optimisation and recruitment.

This is mitigated by external health and safety audit and planned review of all maintenance contracts.

This is mitigated by our fundraising and retail strategies monitored through Board committees.

This is mitigated through corporate governance policies and processes, with a particular focus on compliance with Care Quality Commission key lines of enquiry.

This is mitigated through quarterly review of investment strategy by Finance and Resources Committee

Governance

The Board has ultimate responsibility for the governance and leadership of Royal Trinity Hospice. The Board is responsible for strategic decisions and for monitoring the organisation’s performance and ensuring that it complies with its Articles of Association and applicable laws and regulations.

The Board works closely with the Chief Executive Officer and the Executive team to set our strategy and monitor performance and risk management. The Board meets quarterly and works through three board committees (Finance and Resources Committee, People and Culture Committee and Patient Services Committee) and closely with the board of our retail subsidiary.

In December, we reshaped our internal governance structure to put in place clearer lines of management and leadership responsibility. Where required, internal interdisciplinary groups are in place to improve compliance and quality and reduce incidents and risk.

Board of Trustees

Hospice Executive Committee

Quality Committee Corporate Governance Committee

Operations and Transformation Committee

People Committee Finance Committee

Patient Services Committee

People and Culture Committee

Trinity Shops Board

Finance and Resources Committee

Clinical governance

Trinity’s Clinical Governance Committee meets quarterly to review clinical risk management, clinical audits and clinical staff development and reports to trustees through the Patient Services Committee.

Where required, internal interdisciplinary groups have been established to improve compliance with quality standards and to better mitigate and manage organisational risks. We plan to strengthen this even further through introducing the national Patient Safety Incident Response Framework next year.

As a result, there is a renewed culture of learning, improvement and incident reporting. The enhanced scrutiny that our processes, policies and governance have seen has led to improved incident reporting, a reduction in falls, medications

and health & safety incidents and an inyear improvement in IPC compliance. We are confident that the right foundations are in place to ensure that the new services rolled out next year will be supported by strong governance and quality measures.

Our Clinical Governance Framework ensures we deliver our vision of excellence in patient care and meets both the needs and expectations of patients and the standards set by the Care Quality Commission and National Institute for Health and Care Excellence (NICE) guidance on specialist palliative care.

Trinity’s Medical Director is our Clinical Lead, Caldicott Guardian and Freedom to Speak Up Guardian. Our Chief Executive has overall responsibility for the Clinical Governance Framework.

Environmental reporting

Under the Energy and Carbon Report Regulations 2018, Trinity is required to report on the environmental impacts of the organisation. The key environmental impacts for Trinity are gas and electricity use across the hospice and in our shops; use of pool cars for community nursing visits; and two leased vans used for retail delivery and collections.

We have calculated energy usage using opening and closing meter readings across our sites and for our vehicles. Scope 1 emissions for gas usage and use of owned and leased vehicles are reported.

Hospice emissions have reduced slightly year on year. In 2022 we launched our sustainability strategy and launched an Environmental Sustainability Group, chaired by the Director of Finance and Resources, to look at Co2 emissions across the hospice, particularly in our higher emission areas of waste and energy. We are investigating replacing our current fleet of petrol and diesel vehicles with e-bikes and electric cars which are used for making home visits. We are reviewing waste management to see where we can reduce, reuse and recycle if possible, sending waste to landfill only as a last resort.

In March 2023 our Retail team launched their “Sustainable Seven” a plan focused on reducing emissions in seven key areas of the retail business, including Transportation, Procurement, Waste, Recycling, Printing,

Utilities and Training & Education. Last year our retail team saved 350,000 items from landfill by rehoming these preloved items within our community.

Our Retail Stock and Logistics team has worked to streamline routes and collection days and maximise their loads to improve efficiency and reduce miles per vehicle per week. Where possible and practical, shop delivieries have been moved to off peak to ensure less idling time and quicker routes, all helping to improve fuel efficiency and emissions.

Retail annual mileage has reduced due to drivers moving to 3 day working weeks which has seen a significant reduction in mileage although our volumes and capacity has actually increased.

Our people

In 2022 we launched our new People Plan to support the delivery of our five year strategy. This will only be possible through investing in our workforce by attracting, recruiting and retaining diverse and talented staff and volunteers to genuinely become an employer of choice and charity of choice for volunteers.

A year after the launch of the People Plan for staff we have had success in meeting our goals:

> Attraction we have refreshed recruitment packs and explored new marketing channels as part of a programme to address the current ongoing shortage of qualified nurses. We have introduced a management development programme for managers and senior leaders.

> Recruitment we introduced an applicant tracking system for a user-friendly and anonymised application and recruitment process and we have overhauled the induction and onboarding process for a streamlined joiner experience.

> Retention we have refocused our work to raise awareness around FREDIE (fairness, respect, equality, diversity, inclusion, engagement) which has included working towards our Investing in Diversity re-accreditation and increasing the representation of BAME staff in management roles. We have enhanced our staff wellbeing offer with improved flexible working, employee pay and benefits. We introduced the first Trinity Staff Excellence awards and strengthened staff engagement through learning from staff surveys. Overall staff turnover has improved as a result.

We engage with staff and volunteers in a variety of ways to continue meeting our commitment to delivering outstanding care and support to our patients, their families and friends in the hospice and the community in which we serve.

Disability Equality Statement

Our approach to disability equality in the workplace is to ensure that our processes are fair and consistent, and that we comply with legal requirements and FREDIE principles to genuinely become an employer and charity of choice. We will not tolerate disability discrimination.

Royal Trinity Hospice is committed to creating an environment where people feel safe and comfortable to disclose and talk about disability.

Attraction – We aim to attract the best talent, removing any barriers and ensuring disabled people get support and are not put at a disadvantage or treated less favourably.

We are a Disability Confident Committed employer (currently working towards level 2).

Recruitment – We want to ensure candidates with disabilities have a positive experience.

We have a commitment to interview all candidates with a disability who meet the minimum criteria for a job vacancy and consider them on their abilities.

Reasonable adjustments to the job description, person specification, selection criteria, and hours of work will be considered where reasonable, and practicable.

Retention – Support employees with Access to Work applications and employees who acquire a disability or long-term health condition.

We offer work experience and voluntary work opportunities to increase skills in partnership with disability charities.

We aim to retain staff who often have more resilience and problem-solving skills through developing ways of living with a disability.

Section 172 (1) statement

Trinity’s Directors have acted in accordance with their duties codified in law, which include their duty to act in the way in which they consider, in good faith, would be most likely to promote the success of the organisation for the benefit of its members as a whole, having regard to the stakeholders and matters set out in section 172(1) of the Companies Act 2006. Considerations of the factors that contribute to the success of the organisation for the benefit of its members as a whole are embedded in decision making at Board level and throughout the organisation. The sections in this report which cover our service performance and how we met our strategic objectives last year also detail how we engage with health and social care stakeholders, such as healthcare professionals and patients and their families. We serve a clearly defined geographic area, and engaging our local community in fundraising, volunteering and employment is vital to our work.

Executive team

The Executive team consists of the key management personnel for the purposes of FRS102. The team comprises the Chief Executive, Medical Director, Director of Human Resources and Organisational Development, Director of Patient Services, Director of Finance and Resources, Director of Retail, Director of Nursing and Director of Fundraising (an employee of Compton Fundraising Consultants Ltd). The Chief Executive, with the support of the Executive team, reports to the Board of Trustees, which approves Trinity’s strategic objectives, annual budget and priorities.

The Remuneration Committee determines annually the policy for staff remuneration, including the Chief Executive and the Executive team. Salaries are aligned to the NHS Agenda for Change (AFC) guidelines and process. For all other staff it is benchmarked against appropriate comparable organisations.

The Board of Trustees

The trustees met five times in 22/23 and held two strategic planning days. Trustees are not paid for the duties they undertake and are recruited in accordance with Trinity’s Trustee Appointment and Re-appointment Policy.

All trustees have access to the Company Secretary for advice and relevant services. New trustees undergo an orientation day to:

> brief them on their legal obligations under charity and company law

> review the content of the Memorandum and Articles of Association, the committee and decision-making processes, the business plan and the recent financial performance of the charity

> spend time in our services meeting patients, carers, staff and volunteers

Trinity is a company limited by guarantee and has no share capital. Individual trustees are members of the company. In the event of the charity being wound up, the liability in respect of the guarantee is limited to £1 per member of the charity. Members are liable for a period up to one year after they cease membership.

Staff committees and groups

Trinity’s Staff Involvement Committee meets quarterly with Executive team representatives to discuss changes required or being proposed and raise any matters or concerns to be addressed. Last year the committee were consulted on topics such as Trinity’s anti racism statement.

73% of our staff took part in the staff survey in November 2022.

The Social Committee meets to organise fun events and activities to bring together staff from across Trinity. In the last year they have organised games on Clapham Common, Summer and Christmas parties, Bake Off among other activities.

Trinity’s FREDIE steering group (formerly Investing in Diversity Steering group) consists of staff from across the organisation at all levels including the Chief Executive who provides oversight and direction to our work to promote and advance our FREDIE (Fairness, Respect, Equality, Diversity, Inclusion & Engagement) commitments and action plans. With close involvement from Trinity’s Anti-Racism Action Group (formerly Black Lives Matter at Trinity Working group), the Senior Leadership team and the Board of Trustees, the FREDIE group developed Trinity’s Anti-Racism Action Statement. This committed to becoming a genuinely antiracist organisation through understanding and addressing racial bias, listening,

learning, and acting in response to racism and strengthening our accountability.

Volunteers

Our vision is to be the charity of choice for volunteers in London through realising the potential of our volunteer teamwork. From complementary therapies to café, spiritual care to shops and horticulture and helping in the head office, all our volunteers contribute to our patients and their loved ones continuing to receive outstanding care.

The Trinity volunteer programme is back to full strength and we launched the new two-year People Plan for Volunteers in 2022. This strategic framework outlines how we intend to attract, recruit, and retain diverse, dedicated, and motivated Trinity volunteers to genuinely become a charity of choice. So far, we have trialled lowering the age limit of student and youth volunteers; introduced new volunteering roles e.g., repair shop volunteers and worked closely with the Community Engagement team to involve new groups of volunteers that reflect the local community we serve.

In the last year we have also sent quarterly newsletters keeping volunteers informed of what is happening at Trinity and held a Christmas Party and Long Service Awards event to thank our wonderful volunteers.

Relationships with other organisations

Trinity maintains close links with all local providers who provide care at the end of life in both the voluntary sector and the primary and acute health care sectors. This includes hospitals, care homes, homelessness hostels, GP surgeries etc.

We work closely with hospices across London and the wider UK as well as other organisations and charities, on issues of mutual concern. We are members of several representative bodies (e.g. Hospice UK, Charity Retail Association).

We participate in clinical studies led by academic institutions (see our Quality Account for more information).

Legal and administrative information

Members of the Board of Trustees during the year ended 31 March 2023

Adrian Williams

Professor Suzanne Shale

Jonathan Kembery

James Piper

Heather Blake

Sir Andrew Dillon

Gerard Manley

Chair of the Board of Trustees (term ended 30 June 2023)

Chair of the Board of Trustees (from 30 June 2023)

Deputy Chair. Member of Finance and Resources Committee

Honorary Treasurer and Chair of Finance and Resources Committee

Chair of Patient Services Committee

Chair of Patient Services Committee

Tessa Moore (resigned 13 December 2022)

Alison Petit

Angela Dawe

Angela Marcelle

David Carmalt

Arvind Tewari

Stefan Laban

Rochelle Roest

Member of Finance and Resources Committee and People and Culture Committee

Member of Patient Services Committee and People and Culture Committee

Member of People and Culture Committee

Member of Finance and Resources Committee

Director of Trinity Hospice Shops Limited

Member of Patient Services Committee (resigned 9 May 2023)

Royal Patron

Her Majesty The Queen

Patrons (as at the date of these accounts)

The Earl of Snowdon

The Bishop of Southwark

Richard Briance

Guy Dawson

Huw Edwards

Sir Michael Hintze KCSG, AM

Alexander S Hoare

Patrick Hurst

Richard Lockwood

Lady Virginia Tate

Barry Townsley CBE

Derek Wyatt

Chief Executive

Company Secretary

Principal Advisers

Bankers

Bankers

Auditors

Emily Carter

Sara Griffin (resigned July 2023)

Stephen Hooper (from August 2023)

Messrs C Hoare & Co., 37 Fleet Street, London, EC4P 4DQ

Barclays Bank plc., Level 27

One Churchill Place, London, E14 5HP

Saffery LLP, 71 Queen Victoria Street, London, EC4V 4BE

Public benefit statement

The aims of the charity fall within the criteria of the Charities Act 2011 and thereby the organisation, which has been established exclusively for charitable purposes, is for public benefit.

In planning the activities for the year, the trustees have given careful regard to the Charity Commission’s guidance on public benefit and considered its implications for the charity.

Responsibilities of the Board of Trustees

The trustees (who are also directors of Royal Trinity Hospice for the purposes of company law) are responsible for preparing the Trustees’ Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and the group and of the incoming resources and application of resources, including the income and expenditure, of the group for that period. In preparing these financial statements, the trustees are required to:

> Select suitable accounting policies and then apply them consistently;

> Observe the methods and principles in the Charities SORP;

> Make judgements and estimates that are reasonable and prudent;

> Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in business;

> State whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements.

The trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and the group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

In so far as the trustees are aware:

> There is no relevant audit information of which the charitable company’s auditor is unaware; and

> The trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information.

This annual report is published on the Royal Trinity Hospice website at www.royaltrinityhospice.london/our-finances-and-pay

Auditors

A resolution proposing that Saffery LLP be re-appointed as auditors of the hospice will be put to the Annual General Meeting.

This Trustees Report and incorporated Strategic Report was approved by the Board of Trustees on 26 September 2023 and signed on their behalf by:

Prof Suzanne Shale

James Piper Chairman of the Board of Trustees Treasurer

Independent auditor’s report to the members of Royal Trinity Hospice for the year ended 31 March 2023

Opinion

We have audited the financial statements of Royal Trinity Hospice (the ‘parent charitable company’) and its subsidiaries (the ‘group’) for the year ended 31 March 2023 which comprise the group statement of financial activities, the group and charity balance sheets, the group cash flow and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102, the Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

> Give a true and fair view of the state of the affairs of the group and the parent charitable company as at 31 March 2022 and of the group’s incoming resources and application of resources, including its income and expenditure, for the year then ended;

> Have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and

> Have been prepared in accordance with the requirements of the Companies Act 2006.

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the group and parent charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard,

and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the group or the parent charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The trustees are responsible for the other information. The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in

the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information; we are required to report that fact.

We have nothing to report in this regard.

Other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit:

> The information given in the Trustees’ Annual Report which includes the Directors’ Report and the Strategic Report for the financial year for which the financial statements are prepared is consistent with the financial statements; and

> The Trustees’ Annual Report which includes the Directors’ Report and the Strategic Report has been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the group and the parent charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ Annual Report and Strategic Report.

We have nothing to report in respect of the following matters where the Companies Act 2006 require us to report to you if, in our opinion:

> Adequate accounting records have not been kept by the parent charitable company, or returns adequate for our audit have not been received from branches not visited by us; or

> The parent charitable company financial statements are not in agreement with the accounting records and returns; or

> Certain disclosures of trustees’ remuneration specified by law are not made; or

> We have not received all the information and explanations we require for our audit.

Responsibilities of Trustees

As explained more fully in the Statement of Trustees’ Responsibilities set out on page 30, the trustees (who are also the directors of the parent charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of the financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the group and the parent charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the group or the parent charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

We have been appointed as auditors under the Companies Act 2006 and report in accordance with regulations made under that Act.

Our objectives are to obtain reasonable assurance about whether the group and parent financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The specific procedures for this engagement and the extent to which these are capable of detecting irregularities, including fraud are detailed below.

Identifying and assessing risks related to irregularities:

We assessed the susceptibility of the group and parent charitable company’s financial statements to material misstatement and how fraud might occur, including through discussions with the trustees, discussions within our audit team planning meeting, updating our record of internal controls and ensuring these controls operated as intended. We evaluated possible incentives and opportunities for fraudulent manipulation of the financial statements. We identified laws and regulations that are of significance in the context of the group and parent charitable company by discussions with trustees and updating our understanding of the sector in which the group and parent charitable company operate.

Laws and regulations of direct significance in the context of the group and parent charitable company include The Companies Act 2006 and guidance issued by the Charity Commission for England and Wales.

Further, the parent charitable company is subject to other laws and regulations where the consequences of non-compliance could have a material effect on amounts or disclosures in the financial statements; through a significant fine, litigation, prosecution or restrictions on the parent charitable company’s operations. We identified the most significant laws and regulations to be those issued by the Care Quality Commission (‘CQC’) covering the provision of health and social care in England.

Audit response to risks identified: We considered the extent of compliance with these laws and regulations as part of our audit procedures on the related financial statement items including a review of financial statement disclosures. We reviewed the parent charitable company’s records of breaches of laws and regulations, minutes of meetings and correspondence with relevant authorities, including the CQC, to identify potential material misstatements arising. We discussed the parent charitable company’s policies and procedures for compliance with laws and regulations with members of management responsible for compliance.

During the planning meeting with the audit team, the engagement partner drew attention to the key areas which might involve noncompliance with laws and regulations or fraud. We enquired of management whether they were aware of any instances of noncompliance with laws and regulations or knowledge of any actual, suspected or alleged fraud. We addressed the risk of fraud through management override of controls by testing the appropriateness of journal entries and identifying any significant transactions that were unusual or outside the normal course of business. We assessed whether judgements made in making accounting estimates gave rise to a possible indication of management bias. At the completion stage of the audit, the engagement partner’s review included ensuring that the team had approached their work with appropriate professional scepticism and thus the capacity to identify non-compliance with laws and regulations and fraud.

There are inherent limitations in the audit procedures described above and the further removed non-compliance with laws and regulations is from the events and transactions reflected in the financial statements, the less likely we would become aware of it. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: www.frc.org.uk/ auditorsresponsibilities. This description forms part of our auditor’s report.

Use of our report

This report is made solely to the parent charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the parent charitable company’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the parent charitable company and the parent charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed. Claire

Saffery LLP is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006

C ons olid ated S tatemen t of Fin an cial A ctivities (in corp oratin g cons olid ated in come and exp end itu re accoun t) for th e year end ed 31 March 2023

Net (expenditure) / income b efore recogn i sed gai n s

Net (expenditure) / income after Tax

General purpose funds and designated funds are both unrestricted funds. The statement of financial activities includes all gai ns and l osses i n t he year All i ncomi ng resources and resources expended deri ve from conti nui ng acti viti es The not es on pages 39 to 50 form part of t hese fi nanci al st at em ent s

Balan ce Sh eets as at 31 March 2023

The not es on pages 39 t o 50 form part of t hese fi nanci al st at em ent s

As permitt ed by t he C om pani es Act , t he i ncom e and expendit ure account of t he parent com pany has not been separat el y present ed i n t he fi nanci al st at em ent s The net l oss of R oyal Tri nit y Hospi ce was (£1, 908, 939) (2022 net i ncom e - £1, 927, 127)

Approved by t he B oard of Trust ees on 26 S ept em ber 2023 and si gned on it s behal f by:

S uzanne S hal e

C hai r

C om pany R egi st rati on No: 2673845 (Engl and and Wal es)

C ons olid ated C ash flow S tatemen t for th e year end ed 31 March 2023

Cash fl ows from i n vesti n g acti vi ti es: Retu rn s on i n vestmen ts

In vesti n g acti vi ti es

Movemen t i n cash and cash equ i val en ts

Cash and cash equivalents at beginning of the year

Cash and cash equivalents at the end of the year (ii )

Notes to th e cash fl ow statemen t

(i ) Recon cili ati on of n et i n come / (exp end i tu re) to n et cash i n fl ow from op erati

266) (3, 446, 842)

1. Accoun ti n g p oli ci es

a B asi s of preparati on b.

The fi nanci al st at em ent s have been prepared i n accordance wit h Accounti ng and R eporti ng by C hariti es: S t at em ent of R ecomm ended P racti ce appli cabl e t o chariti es prepari ng t hei r account s i n accordance wit h t he F i nanci al R eporti ng st andard appli cabl e i n t he UK and R epubli c of Irel and (F R S 102) - (C hariti es S OR P (F R S 102)), t he F i nanci al R eporti ng S t andard appli cabl e i n t he UK and R epubli c of Irel and (F R S 102) and t he C om pani es Act 2006.

R oyal Tri nit y Hospi ce m eet s t he defi niti on of a publi c benefit entit y under F R S 102 The fi nanci al st at em ent s are present ed i n

st erli ng, rounded t o t he nearest pound Asset s and li abiliti es are i niti all y recogni sed at hi st ori cal cost or t ransacti on val ue unl ess ot herwi se st at ed i n t he rel evant accounti ng poli cy not e(s)

The fi nanci al st at em ent s have been prepared on t he hi st ori cal cost basi s except for t he m odi fi cati on t o a fai r val ue basi s for cert ai n fi nanci al i nst rum ent s as speci fi ed i n t he accounti ng poli ci es bel ow

P reparati on of t he account s on a goi ng concern basi s

Gi ven t he st rong reserves positi on t he t rust ees do not see any m at eri al uncert ai nti es regardi ng t he charity's abilit y t o operat e on a goi ng concern basi s

c B asi s of consoli dati on

i ) The consoli dat ed account s of t he group i ncorporat e t he fi nanci al st at em ent s of t he charit y and it s t radi ng subsi di ary com pany, bot h of whi ch were m ade up t o 31 March 2023.

ii ) The agency fee charged by t he subsi di ary t o t he charit y i s t reat ed as part of shops' cost s i n t he consoli dat ed st at em ent of fi nanci al acti viti es (S OF A)

iii ) The i ncom e and expendit ure of t he subsi di ary are di scl osed separat el y i n t he S OF A i v) A separat e S OF A for t he charit y i s not provi ded.

d. Taxati on

Incom e t ax recoverabl e i n respect of donati ons, i nvestm ent i ncom e and l egaci es i s i ncl uded under t he headi ng t o whi ch it rel at es

e Incomi ng resources

i ) All i ncomi ng resources are i ncl uded i n t he S OF A when t he charit y i s l egall y entitl ed t o t he i ncom e and t he am ount can be quanti fi ed wit h reasonabl e accuracy F or l egaci es, entitl em ent i s t he earli er of t he charit y bei ng noti fi ed of an im pendi ng di st ri buti on and t he l egacy bei ng recei ved.

ii ) Where t he charit y has been noti fi ed of m at eri al l egaci es t hat have not been i ncl uded i n t he S OF A (because t he conditi ons for recogniti on have not been m et ), t hi s fact and an estim at e, where possi bl e, of t he am ount s recei vabl e are di scl osed i n t he not es t o t he account s

iii ) Grant s, am ount s ari si ng under NHS cont ract s and t radi ng i ncom e are account ed for on t he basi s of t he am ount recei vabl e for

t he year

i v) Investm ent i ncom e i s account ed for on a recei vabl e basi s, i ncl udi ng recoverabl e t ax.

f Expendit ure

All revenue expendit ure has been dealt wit h t hrough t he S OF A on an accrual s basi s Di rect cost s have been all ocat ed t o t hei r appropri at e functi onal headi ngs Indi rect overheads have been apporti oned t o t hese headi ngs on t he basi s of a fai r estim at e of tim e spent or resources used.

g. Governance and support cost s

Governance cost s i ncl ude t hose cost s associ at ed wit h m eeti ng t he constit uti onal and st at ut ory requi rem ent s of t he charit y and i ncl ude t he audit fees and cost s li nked t o t he st rat egi c m anagem ent of t he charit y.

Governance and support cost s are all ocat ed bet ween t he expendit ure cat egori es on t he st at em ent of fi nanci al acti viti es on a basi s desi gned t o refl ect t he use of t he resource

1. Accoun ti n g p oli ci es (con ti nu ed )

h. S hops' operati ng cost s

C ost s i ncurred i n acqui ri ng shop l eases and im provem ent s t hereon are capit ali sed as i ncurred and depreci at ed over fi ve years

i Investm ent s

F i xed asset i nvestm ent s are val ued at cost Li st ed i nvestm ent s are st at ed at mi d-m arket val ue at cl ose of busi ness on t he bal ance sheet dat e R eali sed and unreali sed gai ns and l osses on i nvestm ent s are account ed for i n t he S OF A

j Investm ent propert y

Investm ent properti es are hel d at fai r val ue, deem ed t o be m arket val ue C hanges i n t he m arket val ue of i nvestm ent properti es are t aken t o t he S OF A

k. Depreci ati on

Depreci ati on i s cal cul at ed so as t o writ e off t he cost of t angi bl e fi xed asset s on a st rai ght li ne basi s over t hei r expect ed useful li fe as foll ows:

- F reehol d propert y

25 years

- F reehol d propert y im provem ent s 20 years

- Equi pm ent , fi xt ures and fitti ngs

- C om put er equi pm ent

l S t ocks

5 years

4 years

m F i nanci al i nst rum ent s

The charit y onl y has fi nanci al asset s and fi nanci al li abiliti es of a ki nd t hat quali fy as basi c fi nanci al i nst rum ent s B asi c fi nanci al i nst rum ent s are i niti all y recogni sed at t ransacti on val ue and subsequentl y m easured at t hei r settl em ent val ue wit h t he excepti on of bank l oans whi ch are subsequentl y m easured at am orti sed cost usi ng t he effecti ve i nt erest rat e m et hod.

n. Operati ng l eases

R ent al s payabl e under operati ng l eases are charged on a st rai ght li ne basi s over t he t erm of t he l ease Any rent premi um s are writt en off imm edi at el y.

o. Desi gnat ed funds

R oyal Tri nit y Hospi ce m ay, at it s di screti on, set asi de funds for speci fi c purposes whi ch woul d ot herwi se form part of t he general reserves of t he organi sati on S peci fi call y, funds are set asi de whi ch represent t he i nvestm ent m ade or t o be m ade i n buil di ngs and equi pm ent for use by t he charit y Ot her funds are set asi de t o represent t he t rust ees' commitm ent t o fut ure proj ect s As such, t hey are not avail abl e for ot her purposes

p. R est ri ct ed funds

Di st ri buti ons from rest ri ct ed resources m ust be used for purposes consi st ent wit h donor i nt enti ons and shoul d be t he fi rst source of fundi ng t o support programm es and acti viti es m eeti ng t he rest ri cti on.

q. Unrest ri ct ed funds

General funds are funds whi ch are avail abl e for t he general purposes of t he charit y These funds will be spent i n a way t hat t he t rust ees see fit i n accordance wit h t he st at ed obj ecti ves of t he charit y.

r P ensi ons

R oyal Tri nit y Hospi ce cont ri but es t o t wo pensi on schem es on behal f of it s em pl oyees The fi rst i s a group personal pensi on schem e, whi ch i s a defi ned cont ri buti on schem e The second i s t he Nati onal Healt h S ervi ce P ensi ons Agency schem e, whi ch offers defi ned benefit s t o it s m em bers Thi s i s an approved m ulti -em pl oyer schem e as defi ned i n F R S 102 and accordi ngl y i s account ed as a defi ned cont ri buti on schem e

C onsequentl y t he paym ent s under bot h schem es are charged t o t he S OF A as t hey becom e payabl e S t ocks com pri se unsol d donat ed goods and goods purchased for resal e Unsol d donat ed goods are not val ued for bal ance sheet purposes si nce t he amount i s uncert ai n and t he di rect ors of t he subsi di ary com pany consi der t hei r val ue t o be imm at eri al Goods purchased for resal e are val ued at t he l ower of cost and net reali sabl e val ue

2. In vestmen t i n come

3. Net i n come from T ri n i ty H osp i ce Sh op s L i mi ted

The charit y has a wholl y owned t radi ng subsi di ary, Tri nit y Hospi ce S hops Limit ed, whi ch i s i ncorporat ed i n Engl and and Wal es (com pany num ber 01946988, regi st ered offi ce 30 C l apham C omm on Nort hsi de, London, S W4 0R N) and undert akes t wo m ai n acti viti es:

i ) The com pany act s as agent i n selli ng donat ed goods on behal f of t he charit y.

ii ) The com pany conduct s, as pri nci pal , t he t radi ng acti vit y of selli ng greeti ng cards and ot her m erchandi se

The profit s ari si ng are donat ed t o t he charit y by an annual paym ent under Gi ft Ai d.

At 31 March 2023 t he com pany had 20 t radi ng shops (2022 - 19 shops)

Under t he t erm s of t he agency agreem ent , all i ncom e from t he sal e of donat ed goods t ot alli ng £6,076,813 for t he year (2022: £5,126,502) i s passed di rectl y t o t he charit y Thi s i ncom e i s t herefore not i ncl uded i n t he profit and l oss account of t he t radi ng subsi di ary, as shown bel ow The charit y i s charged an agency fee by t he subsi di ary whi ch i s shown as i ncom e i n t he subsi di ary com pany' s profit and l oss account The agency fee equal s t he expenses i ncurred i n selli ng of goods

T ri n i ty H osp i ce Sh op s L i mi ted p rofi t and l oss for th e year end ed 31 March 2023

ve

and l oss account for 2022 i s as foll ows:

Tri n it y H ospi ce Sh ops Limit ed profit an d l oss for t h e year en ded 31 March 2022

Incom e from t he sal e of donat ed goods i s not i ncl uded i n t he subsi di ary com pany' s profit and l oss account

Comp ri si n g:

6. Net i n come for th e year Thi s i s st at ed aft er chargi ng:

Agency and cont ract st aff i n 2023 i ncl udes £720, 000 (2022: £579, 467) re cont ract ed out fundrai si ng and P R servi ces

Termi nati on paym ent s of £22, 336 were pai d t o 3 m em bers of st aff i n t he year

F or quali fyi ng R oyal Tri nit y Hospi ce st aff, parti ci pati on i n t he NHS schem e provi des benefit s based upon fi nal pensi onabl e pay However, t he cont ri buti ons pai d by t he charit y i n respect of t he NHS S uperannuati on schem e are account ed for as i f t he schem e was a defi ned cont ri buti on schem e as t he charit y i s unabl e t o i denti fy it s share of t he underl yi ng asset s and li abiliti es i n t he schem e

The t ot al pensi on cost for t he year ended 31 March 2023 for t he R oyal Tri nit y Hospi ce was £365, 749 (2022: £311, 122) The Governm ent Act uary, usi ng t he P roj ect ed Unit Met hod, det ermi nes cont ri buti ons charged t o t he S t at em ent of F i nanci al Acti viti es

The NHS P ensi on S chem e i s an unfunded, defi ned benefit schem e t hat covers NHS em pl oyers, general practi ces and ot her bodi es all owed under t he di recti on of t he S ecret ary of S t at e i n Engl and and Wal es As a consequence it i s not possi bl e for R oyal Tri nit y Hospi ce t o i denti fy it s share of t he asset s and li abiliti es of t he underl yi ng schem e

Accounti ng val uati on:

A val uati on of schem e li abilit y i s carri ed out annuall y by t he schem e act uary (currentl y t he Governm ent Act uary’s Departm ent ) as at the end of the reporting period. This utilises an actuarial assessment for the previous accounting period in conjunction with updated membership and financial data for the current reporting period, and are accepted as providing suitably robust figures for financial reporting purposes. The valuation of scheme liability as at 31 March 2023, is based on valuation data as 31 March 2022, updated to 31 March 2023 wit h summ ary gl obal m em ber and accounti ng dat a In undert aki ng t hi s act uari al assessm ent , t he m et hodol ogy prescri bed i n IAS 19, rel evant F R eM i nt erpret ati ons, and t he di scount rat e prescri bed by HM Treasury have al so been used.

F ull act uari al val uati on:

The purpose of t hi s val uati on i s t o assess t he l evel of li abilit y i n respect of t he benefit s due under t he schem es (t aki ng i nt o account t hei r recent dem ographi c experi ence), and t o recomm end cont ri buti on rat es payabl e by em pl oyees and em pl oyers The l ast publi shed act uari al val uati on undert aken for t he NHS P ensi on S chem e was com pl et ed for t he year endi ng 31 March 2016 The result s of t hi s val uati on set t he em pl oyer cont ri buti on rat e payabl e from April 2019 t o 20 6% of pensi onabl e pay.

The act uari al val uati on as at 31 March 2020 i s currentl y underway and will set t he new em pl oyer cont ri buti on rat e due t o be im pl em ent ed from April 2024.

T

No rem unerati on was pai d t o any m em ber of t he B oard of Trust ees duri ng t he year, or t he previ ous year; expendit ure t ot alli ng £7, 477 (2022: £1, 044) was spent on t rust ee t rai ni ng. During the year no expenses were reimbursed to trustees (2022: none)

Trust ee donati ons t o R oyal Tri nit y Hospi ce were £7, 195 (2022: £27, 045)

The C harit y purchased i nsurance for B oard Mem bers and offi cers of t he com pany duri ng t he year t o i ndem ni fy t hem agai nst possi bl e li abiliti es i ncurred i n rel ati on t o t hei r duti es

The cost of t he i nsurance was £913 (2022: £268)

The key m anagem ent personnel of t he group, parent charit y and t he wholl y owned subsi di ary com pri se of t he t rust ees, t he C hi ef Executi ve Offi cer, t he Medi cal Di rect or, t he Di rect or of F i nance and R esources, t he Di rect or of HR & OD , t he Di rect or of P ati ent S ervi ces and t he Di rect or of R et ail

The t ot al em pl oyee benefit s of t he key m anagem ent personnel was £665, 286 (2022: £596, 302)

e average nu mb er of emp l oyees, an al ysed b y fun cti on was: Freeh ol d p rop erty H osp i ce equ i p men t Compu ter equ i p men t G roup and Ch ari ty total B ank (zero cont ract hours) and agency st aff have not been i ncl uded i n t he st aff num bers

N otes to th e C ons olid ated Fin an cial S tatemen ts for th e year end ed 31 March 2023

10. In vestmen t p rop erty

The i nvestm ent propert y i s The Elm s, 29 C l apham Nort hsi de Thi s was previ ousl y part of t he hospi ce and has now been convert ed i nt o fl at s The i nvestm ent propert y val uati on was undert aken i n June 2023 by Kat heri ne Goddard who i s regi st ered wit h t he R oyal Instit uti on of C hart ered S urveyors The val uati on shows t hat t he m arket val ue of t he propert y has decreased t o £4, 900, 000.

roup and Ch ari ty

Less: Di sposal s at Openi ng Val uati on -

eval uati on t o MV (100, 000)

c) In vestmen ts con si d ered materi al i n th e con text of th e mark et val u e of th e p ortfoli o

We have no i nvestm ent s t hat we consi der m at eri al i n t he cont ext of t he m arket val ue of t he port foli o.

We have £1, 655, 685 of cash hel d for i nvestm ent but avail abl e for use as worki ng capit al i f requi red. G

Restricted income funds are for various aspects of patient services and £30,132 transfer between funds is restricted income funds used for the purchase of fixed assets within the inpatient unit.

The i ncom e funds of t he charit y i ncl ude t he foll owi ng desi gnat ed funds whi ch have been set asi de out of unrest ri ct ed funds by t he B oard of Trust ees for speci fi c purposes:

16. Un restri cted fund s (con ti nu ed ) Pri or Year C om pari son

di n g fun d

of Grou p Net A sset s bet w een F un ds

R oyal Tri nit y Hospi ce i s a com pany limit ed by guarant ee and has no share capit al In t he event of t he charit y bei ng wound up, t he li abilit y i n respect of t he guarant ee i s limit ed t o £1 per m em ber of t he charit y Mem bers are li abl e for a peri od up t o one year aft er t hey cease m em bershi p.

At 31 March 2023 t here were t he foll owi ng t ot al commitm ent s under non-cancell abl e operati ng l eases wit h respect t o t he charit y shops:

19. C om parati ve S t at em en t of F i n an ci al A cti viti es Gen eral pu rpose R est ri ct ed

Royal Trinity Hospice is a charity registered in England and Wales, number 1013945, and a company limited by guarantee, number 2673845.

The functions of the hospice are governed by the Articles as amended by Special Resolution passed on 11 September 2020.

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@trinityhospice

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